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Should the pelvic lymph nodes go too??? Should the pelvic lymph nodes go too???

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Unread 11-03-2003, 05:52 AM
Only Your Doctors Can Answer Why

Susanne and Jan--

Only your surgeons can answer why they did not remove any lymph nodes during your surgery. Since endometrial cancer has been surgically staged since 1988, and part of the staging includes determining whether the cancer has spread to the lymph nodes, it does not appear to be possible to do complete surgically staging without removing and testing some lymph nodes. Perhaps they did not feel full surgical staging was necessary, but they need to explain to you their thought processes for not sampling any lymph nodes so that you are comfortable with their decision not to do so. I would, of course, first make sure that the pathology report does not state that lymph nodes were part of the surgical specimen evaluated by the pathologist to be sure what your surgeons told you is factually correct.

If your surgeons do not answer this question to your satisfaction, if it were me, I would consider going for a consult with another gynecologic oncologist who can adequately address the issue for you.

Best regards.

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Unread 11-03-2003, 09:37 AM
Should the pelvic lymph nodes go too???

THanks Moe Kay - I do have a copy of my pathology and surgical reports - and no lymph nodes were taken. I did ask my Dr why she didn't remove any and she said the cancer was so early, and they looked at the lymph nodes and they were healthy. She told me the lymph node removal is only necessary if the cancer has penetrated the myometrium and/or there is visual evidence of spread into the lymph nodes.
My GYN/ONC was not present at the surgery, but the urologist/ONC was. He would have removed the lymph nodes if they found it necessary.
When I went to see the GYN/ONC he went over the path/surgical reports and concurred with my GYN.
I am going to call the ONC's office today and ask again.

Unread 11-03-2003, 10:27 AM
Should the pelvic lymph nodes go too???

Thanks Moekay, I need to follow-up on this issue again.

Jan - I'd be interested in what your onc says to you, also ~


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Unread 11-03-2003, 11:51 AM
no lymph nodes

I was staged 1A, grade1 and my doctor told me that it was not necessary to go further. She looked at everything.. organs, lymph nodes etc. and my pathology report confirms. It indicated that the tumor or cancer in the uterus was high up and very superficial. I too wonder if it's all gone for real or not and probably would wonder even if they did sample some of the nodes. I'm confident that my doctor knew what she was doing, the gyn/onc was there watching and it was both of their opinions it wasn't necessary to go further. I'm grateful I was so lucky...
Unread 11-04-2003, 05:40 AM
Should the pelvic lymph nodes go too???

I did not know I had ovca until they pathology was performed so there was no staging or removal of lymph nodes - they didn't think it was necesary. It was confined to one ovary (stageI) and the doc/onc suggested chemo to ensure everything was removed. I asked about going back in to stage and look at the lymph nodes and he said that if there were anything left behind, the chemo would take care of it. I'm completed with my second round of chemo but won't know the CA #'s till next week. I they go down I'm ok, if they go up, they'll do another CT scan to see if they lymph nodes are afftected. I'm not going to mess with seeing if they go away with chemo - I want them surgically removed! Prognosis for my stage is execellent but when things like this happen it scares the heck out of you!

Take care.

Unread 11-04-2003, 05:27 PM
Should the pelvic lymph nodes go too???

I also did not have lymph nodes sampled or removed although my dx was endometrial carcinoma stage 1b; both my gyn and the gyn/onc who assisted in the operation concluded that it was not necessary. When I asked why, they indicated my particular situation did not require this to be done based on many medical factors including: the invasion was very minimal and location and tumor size was tiny and confined; healthy appearance of lymph nodes (they insisted on a vertical incision to allow viewing of as many lymph nodes as possible), good CATSCAN, good blood tests, clean surgical washings. My doctors are experts in their fields and I have strong confidence in their medical judgment in my case. Blessings, peggiesue
Unread 11-12-2003, 08:34 PM
Should the pelvic lymph nodes go too???

Hi Ladies,

I ended up having 18 nodes removed--all tested negative for cancer. I ended up with stage 1a endo cancer. I am getting physical therapy because the right side of my groin and pelvis got all tightened up--it is helping to release it with the deep myofascial work she is doing. I haven't had any lymphedema yet and am keeping my fingers crossed and pushing myself to do intense exercise--walked for 15 minutes up the steep face of a mountain yesterday and did gentle walking for another hour.

My doctor said that it is her policy now to remove all the pelvic nodes with the radical hysterectomy. SHe said that you cannot tell by looking at the nodes if there is cancer in them unless it is big. She is a professor of gyn/onc. My second opinion doc said that she would only remove them if they looked big which is why I went back to the first doc.

Now they said to go for checkups every 4 months for a look up inside the vagina to see if she sees anything plus a chest xray once per year to see if anything has gone into my lungs.

I bought the book, "What to Eat if You Have Cancer" and have started following many of their recommendations--it leans a little toward vegtable sources of protein. We have also started eating only organic meat and only North Atlantic salmon instead of the farmed stuff that is fed meal with PCB's in it. I did not know that we show only eat peanut products once per week--that is just one of their recommendations.

Good luck to all of you and thank you for the support. As I get farther and farther from my surgery, I can't believe all that I went through in July. A new thing for me is that I don;t have a cold all the time anymore. The year before my surgery, I had a cold most of the time, Iguess my immune system was trying to fight the cancer. My belly is still pretty big, but I have put myself back on Weight Watchers. I lost 11 lbs with the surgery and no-appetite phase, then, as I was processing the fear and shock of my surgery, I gained back 9. I am hoping to drop the 9 or 10 back off, I liked being slimmer.

I am having a funny thing happen--everytime that tight muscle in my groin gets stretched, some memory of the surgery itself comes back to me--it is almost like part of me was concious of the surgery and reacted to it and by stretching out those areas, it is releasing the memories--Strange.

Take care, Love to all of you great people, Alana
Unread 11-13-2003, 01:10 PM
Should the pelvic lymph nodes go too???

Alana, glad to learn the nodes all tested negative and best wishes for a full recovery. Blessings, peggiesue

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